There is a misconception in modern childbirth. It is that childbirth should be painless and easy. Women today are being raised to believe that a ‘painless’ birth is a good birth. The concept of “pain” may have negative connotations for many. The very definition of pain, according to the International Association for the Study of Pain, is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” This definition invokes fear. It does not embody a belief that pain or sensory feedback is designed to be worked with, that pain has a purpose in birth, and that a laboring mother can move through it and embrace it as feedback.
Giving birth is a biological function, an event that women’s bodies have been designed for. Quite simply, if our bodies were unable to give birth, then we would not exist as a species. For generation after generation, for hundreds and thousands of years, our grandmothers gave birth as nature intended. Our grandmothers had other women with them to guide them, teach them, and support them on their birthing journey.
Those guides showed our grandmothers what birth is really like. It taught them that natural birth, the way nature intended, doesn’t mean that it will not hurt. They knew that birth could be both simultaneously blissful and painful. The guides taught our grandmother’s several important tricks for a gentle birth. First, listen to what your body tells you, and remove what is painful when it is painful. Second, put your trust in the process. And third, surround yourself with support during this blessed event. By practicing these three steps, you can surrender to the process and birth with intention and without fear.
It is my experience that this “fear of pain” is something that hinders many mothers in birth. Throughout my years as a birth doula, I have found that there are three sources of pain a laboring mother may experience.
Emotional pain is the fear of the unknown. It often is directly due to a lack of education. Fear is primitive, causing muscles to tense, releasing a rapid production of stress-inducing hormones. As the hormones cortisol and noradrenaline are released, a laboring mother’s heart rate and blood pressure will increase and her muscles will tense. Her sensory focus will narrow, increasing resistance to the experience; she will lose her ability to reason. Her emotions will become all-encompassing and monopolize all her functions. Survival is hardwired, and for first-time mothers, understanding that surrendering into the contractions will actually make them easier to work with is counter-intuitive. By witnessing births, talking with other experienced women, and becoming better informed, a mother can better understand the birthing process and the emotions that go with it. As a mother prepares for her birth, her feelings of control and security increase as her fear of the unknown disappears.
In labor, it can be critical to have someone with you who is emotionally connected to you and is not afraid to ask, “What is your biggest fear right now?” This person can be your partner, coach, sister, or doula. They can be ready to help you process your fear productively. Some women will even joke in labor about their fears. Those offering support can take a few minutes and address a laboring mother’s fear, as needed.
Physiological pain is directly due to the contractions, the descent of the baby, the position the mother is in or the procedures she is exposed to. It is the coach’s goal to keep the mother as relaxed as possible and avoid any unnecessary interventions. There are a few simple but effective reminders that a coach can give to help support the mother during this time. Remind her to take deep, diaphragmatic breaths so she can get the most oxygen to her muscles and her baby. Consider changing her position every 30 minutes or so unless she is relaxed, or appears to be meditating or sleeping. Use upright positions whenever possible to work with gravity. When laboring mothers are upright they find the contractions are typically closer together, but shorter in duration and therefore more manageable. By using gravity, they can also help to align the baby in the pelvis. Side-lying positions may also be comfortable for resting when alternated with upright positions. Pay close attention to clenching of the mother’s jaw, hands, or feet. Clenching or grasping movements can pull the baby up and out of the pelvis. Most mothers make the most progress in labor when they are kept relaxed “like a wet noodle.” Hydration also plays a critical role in preventing dehydration and a dysfunctional labor pattern. Voiding hourly also helps to make space for the baby to descend and makes contractions less intense.
Remember, most women will want pain relief with contractions. But when the contraction is over she can relax, gather her energy, and prepare for the next contraction. The coach’s job is to assist the mother through both the pleasures and pressures of birth, not to “fix” the labor or birthing experience.
Functional pain is additional pressure, with or without contractions, due to deviations in labor. Often this is from a misaligned mother or baby. Most misalignments can be avoided or corrected in pregnancy with proper care. Basic childbirth exercises to strengthen birthing muscles will help to align a baby early. Walking, swimming, and sitting upright with a straight back is all easy to do throughout pregnancy, and have long-lasting rewards for mom and baby. Chiropractic care and acupuncture can help to open the mother’s body and allow a baby to find the right way out. Homeopathy can be an amazing choice for mothers in labor, as well. Also, having a trained birth worker at birth can guide mom and her partner through a variety of positions, as well as instructing them in using advanced techniques like rebozo to help with alignment and to speed the process.
Remember, pain is finite. Pain has a beginning and an end. It will not last forever. In labor, it may be very hard to surrender to the process, but many of the discomforts of birth can be dealt with by having a good support team and a provider and birthplace that will work with your choices. Most emotional pain can be avoided with excellent childbirth preparation and classes. Functional pain can also be alleviated or avoided with proper care and attention to detail. Physiological pain in labor, however, is part of the natural process, working hand-in-hand with a natural endorphin release. This combination of endorphins and hormones is complex and wonderful. When the mother feels safe and supported, the labor process can unfold as needed, transforming women into mothers.
This experience can empower you for the rest of your life. Welcome it, and let birth transform you.
This article appeared in Pathways to Family Wellness magazine, Issue #39.